HEART

Heart
 Circulatory system is the first system to
become functional, due to dependence of
internal transport of other parts to
differentiate and grow.

 The heart develops along the course of

the main blood trunk as a pumping device
for efficient blood circulation.
Position of the heart

 The heart is ventral and

anterior to the gut

 It is about size of a fist, it lies

in a space called the
mediastinum in the left center
of the thoracic cavity with its
apex pointing to the left side.

 Heart is protected by a bony

cage which consists of the ribs
sternum, and the spine.
 Heart

 Embryonic heart has 2 layers:

 Inner Endocardium
 Outer Epimyocardium

 In adults endocardium develops to a mature

Endocardium – thick layer of elastic connective
tissue – strengthen and protect inner lining of the
chambers and valves.
 Heart
In adults Epimyocardium divides into:
 Myocardium, middle layer → muscle of the heart
(cardiac muscles). Two types of cardiac muscle cells:
contractile cells and pacemaker cells. Pacemaker cells
are auto-rhythmicity. Few elastic fibers.

 Pericardium outer layer that surrounds the heart;

pericardial sac,. The pericardium formed by two layers,
outer fibrous layer and inner serous layer. The
pericardium fixes the heart to the mediastinum, gives
protection against infection, and provides the
lubrication for the heart.
 Heart : Pericardium
 Inner Serous layer divides into:
 Parietal pericardium lining the sac. Parietal
pericardium secretes watery lubricant that reduces
friction between the two layers and lubricates the
surface of the heart facilitating movement of the
heart.
 Visceral pericardium (epicardium) covers and protects
the great vessels and heart. The space between the
parietal and visceral layers is called the pericardial
cavity. The pericardial cavity contains pericardial fluid.
This fluid provides protection to the heart and a
lubricated sliding surface within which the heart can
move in response to its own contractions and to the
movement of adjacent structures such as the
diaphram and the lungs.
The Heart
 Heart
 The heart has valves:
1. Aortic valves /semilunar valves at base
of the two arches, between the aortae
and ventricles.

1. Atrioventricular valves between atria

and ventricles – Tricuspid valve on the
right side Bicuspid/mitral valve on the
left side.

2. Pulmonary valve: This is between the

ventricle and the pulmonary artery
Valves of the Heart

Semilunar
or
Flow of blood in the heart
 Coronary circulation
 The myocardium (cardiac muscle) is a
working muscle that has extensive network
of blood vessels that continuously supply
oxygen and nutrients and remove waste
products.

 Thus the heart has its own intrinsic

circulation (the functional supply of the
heart) known as coronary circulation for
efficiency. It is the shortest circulation in the
mammalian body.
 Coronary circulation
 In humans: two main arteries, the right and left
coronary arteries, given off at base of systemic
aorta and encircle the heart within the
atrioventricular (AV) sulcus.

 Left coronary artery supplies blood to the

ventricles anteriorly, most of the posterior wall of
the heart and lateral wall of the left ventricle

 Right coronary artery supplies blood to the

ventricles posteriorly, lateral wall of the right
ventricle, sinoatrial and atriaventricular nodes
 Coronary circulation
 After blood passes through the capillaries in the
myocardium, it enters a system of cardiac
(coronary) veins which includes the great /left
cardiac vein and middle/right cardiac vein.
Most cardiac veins drain into the coronary sinus,
which opens into the right atrium

 4% of left ventricle output  coronary vessels.

Adult at rest, coronary flow – 200ml/min, 70% of
flow during diastole.
 Heart beat
 The heart beat is initiated
by a Sino-Atrial node,
pacemaker in the right
atrium.
 Impulses spread to both
atria (contract) and picked
by atrioventricular node
and conveyed to walls of
Sino- ventricle through the AV
atrial
node bundle of fibers -“bundle
of his” to the apex of
heart and then spread to
Atrioventricular ventricles - contract
node
“Bundle of his” Atria contract before
ventricles.
 Conducting tissue of the heart
 The contraction of cardiac muscle in all animals is initiated
by electrical impulses known as action potentials.
 One percent of the cardiomyocytes in the myocardium
possess the ability to generate electrical impulses (or action
potentials) spontaneously.
 The rate at which these impulses fire controls the rate of
cardiac contraction, that is, the heart rate.
 A specialized portion of the heart, called the sinoatrial node
(SA node), is responsible for atrial propagation of this
potential.
 The sinoatrial node (SA node) is a group of cells positioned
on the wall of the right atrium, near the entrance of the
superior vena cava.
 They are also referred to as pacemaker cells.
 Conducting tissue of the heart
 Below the Sinoatrial node is the Atrioventricular node (AV
node).
 The Atrioventricular node (AV node) is found beneath the
endocardium.
 The AV Node takes the signal from the Sinoatrial node, slows
the signal down and regulates it, and then sends the
electrical impulses from the atria to the ventricles (bundle of
His).
 Atrioventricular Bundle
 The AV bundle (Bundle of His)is a collection of heart muscle
cells specialized for electrical conduction.
 They originate from anterior portion of AV node and ramifies
beneath the endocardium into right and left ventricles.
 The fibres af AV bundle become larger distally into right and
left ventricles and they are called Purkinje fibers.
 These fibers are relatively sparse, displaced to the periphery
and they are less consistent in their orientation.
Cardiac Pacemaker
 Cardiac Pacemaker
 The cells that create these rhythmic impulses, setting the
pace for blood pumping, are called pacemaker cells, and
they directly control the heart rate.
 They make up the cardiac pacemaker, that is, the natural
pacemaker of the heart. In most humans, the concentration
of pacemaker cells in the sinoatrial (SA) node is the natural
pacemaker, and the resultant rhythm is a sinus rhythm.
 Cardiac Pacemaker
 The pacemaker cells are connected to neighboring contractile
cells via gap junctions, which enable them to locally
depolarize adjacent cells.
 Gap junctions are regions of low resistance and allow the
passage of positive cations from the depolarization of the
pacemaker cell to adjacent contractile cells.
 This starts the depolarization and eventual action potential
in contractile cells. Having cardiomyocytes connected via gap
junctions allow all contractile cells of the heart to act in a
coordinated fashion and contract as a unit
 Conducting tissue of the heart
 Bundle of His delivers the wave of excitation to
all regions of the endocardium very rapidly
causing all muscle fibers to contract
synchronously.
SA NODE
 Cardiac Muscle Contraction
 Cardiac impulse originates at SA node
 Action potential spreads throughout right and left atria
 Impulse passes from atria into ventricles through AV node
(only point of electrical contact between chambers
 Action potential briefly delayed at AV node (ensures atrial
contraction precedes ventricular contraction to allow
complete ventricular filling)
 Impulse travels rapidly down interventricular septum by
means of bundle of His
 Impulse rapidly disperses throughout myocardium by means
of Purkinje fibers
 Rest of ventricular cells activated by cell-to-cell spread of
impulse through gap junctions
 Cardiac Pacemaker
 All the while being in sync with the pacemaker cells; this is
the property that allows the pacemaker cells to control
contraction in all other cardiomyocytes.
 Cells in the SA node spontaneously depolarize, ultimately
resulting in contraction, approximately 100 times per
minute. This native rate is constantly modified by the
activity of sympathetic and parasympathetic nerve fibers
via the autonomic nervous system, so that the average
resting cardiac rate in adult humans is about 70 beats per
minute.
 Sympathetic & Parasympathetic
Nervous System
 Sympathetic Nervous System is activated by Emotional of
Physical Stress (Fright, anxiety, excitement, depression and
exercise)

 The Parasympathetic Nervous Sytem reduces heart rate

when stressful condition has passed
 Contraction of the heart
 A cycle of a heart beat has two phases:
 Systole and Diastole

 SYSTOLE is the phase of contraction of the heart

and begins with the atria.

1. As atria contract, atrial pressures increase,

pushing blood into the ventricles.

2. After a delay of about 0.1 second, Ventricle

contract, pressure rises in them and exceeds that
in atria.
 Systole cont
3. Atrioventricular values close, contraction continue.

4. Ventricle form sealed chamber and there is no

volume change, because both atrioventricular and
aortic valves are closed.

5. Pressure increases gradually and exceed that in

aorta, aortic valves open and blood is ejected to
the aorta, ventricle relax. Pressure falls and aortic
valves close again.
 Systole cont
N.B The volume of blood into ventricle by
atria contraction is less than blood to
aorta by ventricle contraction. Ventricle
filling depends also on direct flow from
veins.
 Diastole
DIASTOLE is the period of heart relaxation
 As the heart relaxes, it expands. Volumes of the
ventricles increase until ventricular pressure is lower
than atrial pressure, the AV valves open.

 When heart is relaxed, blood pressure in the veins is

higher than in the atria, which in turn is higher than
the pressure in the ventricles. Blood flows from the
veins into the atria and from the atria into the
ventricles (ventricular filling).

 The diastole lasts 0.4 seconds at rest.

 Atria send the final 25% of blood to the ventricle by

contracting.
 Electrocardiogram (ECG)
Recording of electrical events in the heart by electrodes
placed on body surface.
Electrocardiogram ( ECG) cont
 Blood pressure
 Blood pressure: Arterial pressure: The difference
in pressure across wall of blood vessel during a
cycle of heart beat.

 The lowest blood pressure reached in the arteries

before the next contraction is the Diastolic
pressure (DP) and the maximum arterial pressure
reached is the Systolic pressure (SP)

 For healthy young adult, Systolic pressure

approx.120 millimeters of mercury (mm Hg) and
Diastolic pressure approx. 80 mm Hg .

 Pressure pulse: The difference of SP and DP

 CARDIC OUTPUT
 Cardiac output is the volume of blood pumped by
heart per minute (mL blood/min). Is function of
heart rate and stroke volume.

 Stroke volume is the volume of blood (mL),

pumped out of the heart with each beat. (difference
of volume just before and after ventricle
contraction.)

 Heart rate the number of heart beats per minute.

 Cardic Output cont
 On average resting heart rate is 70 beats/minute
and a resting stroke volume is 70 mL/beat.
Average Cardiac Output at rest is:
= 70 (beats/min) X 70 (mL/beat) = 4900
mL/minute

 The total volume of blood in the circulatory system

of an average person is about 5000 mL. According
to our calculations, the entire volume of blood
within the circulatory system is pumped by the
heart each minute (at rest).

 During vigorous exercise, the cardiac output can

increase up to 7 fold (35 liters/minute)
 Control of Heart Rate
 The SA node of the heart is innervated by
sympathetic and parasympathetic nerve fibers.

 At rest the parasympathetic fibers release

acetylcholine, which slow the pacemaker potential
of the SA node and reduce heart rate.

 Under conditions of physical or emotional activity

sympathetic nerve fibers release
norepinephrine, which acts to speed up the
pacemaker potential of the SA node thus increasing
heart rate.
 Control of Heart Rate cont
 Sympathetic nervous system  release epinephrine
from adrenal medulla. Epinephrine enters blood
stream, and in the heart binds with SA node
receptors. Binding of epinephrine leads to further
increase in heart rate.